Testosterone is a hormone that exists in both males and females and is the primary sex hormone in males. It plays a significant role in the development of male reproductive tissues and secondary sex characteristics, such as increased muscle mass and body hair.
Some people may experience lower than average testosterone levels. This may result in both physical and psychological symptoms.
This article discusses the symptoms, causes, diagnosis, and treatment of low testosterone levels in males. It also discusses low testosterone in females. Finally, it offers advice on when to consult a doctor and answers some common questions about low testosterone levels.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
The American Urological Association (AUA) defines low blood testosterone in males as less than 300 nanograms of testosterone per deciliter of blood.
Males with low testosterone may experience the following symptoms:
The main cause of low testosterone is aging, with older males having lower testosterone levels than younger males. Aging aside, medical professionals divide the causes of low testosterone into
Primary hypogonadism (PH) occurs as a result of an issue with the testicles. The
- undescended testicles
- trauma to the testicles from injury, cancer, radiation therapy, or chemotherapy
- genetic disorders, such as Klinefelter syndrome
Secondary hypogonadism (SH) occurs due to a signaling issue between the brain and the testicles. Such issues stem from one of two parts of the brain: the hypothalamus or the pituitary gland.
Ordinarily, the hypothalamus produces gonadotropin-releasing hormone, which signals the pituitary gland to produce follicle-stimulating hormone and luteinizing hormone. The latter then signals to the testicles to make testosterone.
A problem in the hypothalamus or pituitary gland can disrupt typical testosterone production. Such problems may occur due to
- pituitary disorders
- Kallman syndrome, a condition that involves delayed puberty and an impaired sense of smell
- surgery or trauma
- stress-induced hypogonadism
The diagnostic procedure for low testosterone will likely involve the following:
- An assessment of the person’s symptoms: This may include questions about when the symptoms started and their frequency and severity.
- An assessment of the person’s medical history: This may include questions about the following:
- any history of head trauma, surgery, or irradiation
- any history of infection or injury to the testicles
- any history of chemotherapy or radiation therapy
- any past or present use of drugs, such as glucocorticoids, anabolic steroids, or opiates
- any family history of diseases linked to low testosterone
- A physical examination: During the examination, the doctor may check for the following:
If a doctor suspects low testosterone levels, they will order a total testosterone level blood test, which indicates the testosterone level in the blood. A person needs to take this test early in the morning, when testosterone levels are at their peak.
The doctor may also order blood tests to check levels of luteinizing hormone and prolactin, as atypical levels of either can indicate an issue with the pituitary gland.
People can also use at-home testing kits to determine if they should seek further medical attention for low testosterone.
The treatment for low testosterone will depend partly on the cause.
In some cases, a doctor may prescribe testosterone replacement therapy (TRT). The most common options for TRT are:
- oral testosterone medications
- intranasal testosterone gels
- topical testosterone gels, creams, or patches
- testosterone injections
- implantable testosterone pellets
Where necessary, doctors may also recommend lifestyle changes, such as:
- maintaining a moderate weight
- performing regular exercise
- following a nutritious diet
Side effects and risks
According to the United Kingdom’s National Health Service (NHS), TRT has the potential to cause side effects, including:
- increased appetite and weight gain
- general weakness
- hot flushes
- excessive sweating
Anyone who experiences side effects while taking testosterone should notify their doctor as soon as possible.
A 2014 research group reviewed all available data regarding the therapeutic use of testosterone and other androgens in women. The group concluded that doctors avoid diagnosing androgen deficiency syndrome (ADS) in healthy females due to insufficient data linking androgen deficiency with specific signs or symptoms. Ultimately, the authors stated that ADS in women does not have a clear definition to warrant a formal diagnosis.
The authors add that there is evidence supporting the use of testosterone therapy for postmenopausal women with sexual dysfunction due to hypoactive sexual desire disorder (HSDD).
However, they recommend against prescribing testosterone to women as a treatment for most other conditions, including:
Medical professionals do not recommend population-level screening for low testosterone.
However, if an individual experiences symptoms of low testosterone, they can talk with their doctor about the possibility of medical tests to confirm the diagnosis.
Below are some answers to common questions about low testosterone.
What happens when a male’s testosterone is low?
The level of testosterone in the blood varies considerably throughout the day. Even if there is a significant drop in peak testosterone levels, it is possible to remain asymptomatic. Possible symptoms of low testosterone include:
- decreased libido
- reduced lean muscle mass
- loss of facial or body hair
How do you treat low testosterone?
Treatment methods for low testosterone depend on the cause. A doctor can run tests to help determine the cause and may be able to provide appropriate options.
Certain lifestyle changes may also help address low testosterone levels. These include maintaining a healthy weight, exercising regularly, and eating a nutritious diet.
Does masturbating reduce testosterone levels?
There is no evidence of a link between low testosterone levels and masturbation.
The symptoms of low testosterone levels are generally nonspecific. They may include physical symptoms, such as ED, obesity, and reduced muscle mass, as well as mental symptoms, such as irritability and depression.
Due to the nonspecific nature of symptoms, diagnosing low testosterone can be challenging. Doctors will typically order multiple blood tests to confirm the condition.
The treatment for low testosterone depends partly on the cause. In some cases, maintaining a healthy lifestyle is a safe and effective way to return testosterone levels to expected levels. In other cases, doctors may recommend TRT, though this can cause side effects. A person can discuss TRT’s potential risks and benefits with their doctor.